A gentle treatment of benign prostate enlargement (BPH)

Transurethral resection of the prostate (TUR P) is the standard of surgical treatment for benign prostate enlargement (BPH). This procedure however can cause negative accompanying symptoms. Those symptoms can include prolonged hospitalization, blood transfusions (2% – 8,4%), sustained incontinence (1,5%) and ejaculation disorders (85%) (1). For patients with drug intolerance or exhausted drug treatment the transurethral convective interstitial water vapor ablation with the REZUM system can represent an alternative treatment option, a gentle approach trough the urethra in an outpatient setting.

How does REZUM work?

Hot water vapor will be applied into the adenoma, the benign and enlarged prostate region, through a special endoscope. Depending on the size of the prostate and the area of treatment, which is carefully targeted, the water vapor will cause death of the tissue. Over time the decomposition of the dead tissue will induce a widening to the once narrow prostatic urethra. No heat damage will occur outside of the treatment area (2).

How will anesthesia be performed?

Normally REZUM is being performed under short anesthesia. Sometimes however, general anesthesia is not advisable. For those patients the procedure can be executed under local anesthesia. In that case the urethra, prostate, urinary bladder and the supplying nerve endings will be numbed using a local anesthetic which is injected through the perineum. In addition, a sleeping agent can be administered to make the procedure more pleasant. We will adjust the approach for each patient individually.

What can I expect after REZUM treatment?

The REZUM procedure is conducted in an outpatient setting. After the treatment a temporary urinary catheter is required for 2 to 7 days. The duration depends on your individual situation and the size of the prostate. For patients with urinary retention the catheter should remain a bit longer. The procedure is barely painful. Common pain relieving medication such as ibuprofen or novaminsulfon are usually sufficient. The results however don’t show right away, but rather start to show after 6 weeks und continue to improve up until 6 months.

How well and for how long does REZUM work?

So far studies concerning the REZUM treatment have been carried out for more than five years. Urination difficulties improved by 47% (measured by IPSS questionnaire) and the maximum urinary flow rate improved by 50%. Out of the patients treated with REZUM, 4,4% needed additional surgical treatment and 11,2% resumed medication therapy (1). Therefore, REZUM treatment appears to be superior to medication therapy alone and can prevent or delay more invasive surgical procedures.

For whom is REZUM suitable?

For men

who want to keep their sexual function and ejaculation capability

who are looking for an alternative treatment to medication therapy or for who medication therapy is insufficient

who are looking for an alternative treatment to the standard procedure (TUR P)

who are not eligible for the standard procedure (TUR P)

who want to return quickly to their daily routine after the procedure

who want to return quickly to their daily routine after the procedure

Does my social health insurance (GKV) cover the procedure?

It strongly depends on the insurance company to cover the costs of water vapor ablation. We have special contracts with DAK insurance company in order to perform the surgery without prior approval. For other insurance companies, costs are usually covered on prior request („Kostenübernahmeantrag“).


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What expertise does the team in the Klinik LINKS VOM RHEIN have?

PD Dr. Salem introduced the REZUM procedure in 2019 to the university hospital of Cologne (UKK). Together with PD Dr. Kuru they established the treatment in the Klinik LINKS VOM RHEIN. Since then we have treated not only young patients looking to preserve their ejaculatory function but also older patients with urinary catheters, who are not eligible for standard procedure. In many cases we achieved successful outcomes and at the same time prevented common surgical interventions. The results can not be equated with standard surgical treatment, which has a stronger and longer lasting effect. However potential risks and complications are less likely. Therefore the procedure is not suited for everybody.

Our goal is to provide you with a suitable therapy for your individual situation and needs. We will be happy to advise you.


1. McVary KT, Rogers T, Roehrborn CG. Rezūm Water Vapor Thermal Therapy for Lower Urinary Tract Symptoms Associated With Benign Prostatic Hyperplasia: 4-Year Results From Randomized Controlled Study. Urology. 2019 Apr;126:171-179.
2. Mynderse LA, Hanson D, Robb RA, Pacik D, Vit V, Varga G, Wagrell L, Tornblom M, Cedano ER, Woodrum DA, Dixon CM, Larson TR. Rezūm System Water Vapor Treatment for Lower Urinary Tract Symptoms/Benign Prostatic Hyperplasia: Validation of Convective Thermal Energy Transfer and Characterization With Magnetic Resonance Imaging and 3-Dimensional Renderings. Urology. 2015 Jul;86(1):122-7.